Angiosarcoma of the Bladder: Case Report and Review of the Literature

Williams, Steve K.; Romaguera, Rita L.; Kava, Bruce R.

doi:10.1100/tsw.2008.79

Cited by 16 publications

(13 citation statements)

References 15 publications

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“…[26][27][28][29][30][31][32][33] Bladder angiosarcoma may occasionally exhibit focal keratin immunostaining and rare nuclear GATA3 expression confounding the morphologic overlap. 28,29,34 In the series of 4 bladder angiosarcomas reported by Tavora et al, 28 1 angiosarcoma was associated with high-grade urothelial carcinoma (sarcomatoid carcinoma with heterologous element), the presence of which may further confound its mimicry of pseudoangiosarcomatous carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Pseudoangiosarcomatous Urothelial Carcinoma of the Urinary Bladder

Paner

Cox

Richards

et al. 2014

American Journal of Surgical Pathology

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The pseudoangiosarcomatous pattern has been described mostly in cutaneous and some visceral squamous cell carcinomas and is unique for its striking morphologic resemblance to angiosarcoma. Herein, we describe the clinicopathologic features of 7 pseudoangiosarcomatous urothelial carcinomas that occurred in the urinary bladder. The patients included 6 men and 1 woman ranging in age from 47 to 87 years (median 70 y). The pseudoangiosarcomatous morphology was observed in 7 urothelial carcinomas including 3 with squamous differentiation and comprised 35% to 85% of the invasive tumor. Histologically, the pseudoangiosarcomatous carcinomas were characterized by tumor cell discohesion and lysis that created pseudolumina formations surrounded by attached residual tumor cells. Detached degenerating tumor cells variably admixed with inflammatory cells were common in the false lumina. Partly intact urothelial carcinoma nests contained irregular or cleft-like spaces and disintegrating tumor cells with stretched intercellular bridges. The tumor was commonly associated with a dense collagenous matrix, often surrounding the lytic nests. Similar tumor cell discohesion and breakdown were observed in 3 tumors with foci of squamous cell differentiation, distinguished by the presence of dyskeratosis and keratin formation. All 7 tumors contained other nonpseudoangiosarcomatous carcinoma components such as conventional urothelial carcinoma (5), squamous differentiation (4), sarcomatoid spindle cell carcinoma (2), small cell carcinoma (1), micropapillary carcinoma (1), and glandular differentiation (1). The pseudoangiosarcomatous urothelial carcinomas were all (7/7) diffusely CK7 positive, most (6/7) were GATA3 positive, and none (0/7) expressed vascular-associated markers. There was no evidence to suggest that apoptosis (by TUNEL assay and cleaved caspase-3 immunostaining) or loss of the adhesion molecules CD138 and e-cadherin were possible causes for the tumor cell discohesion and breakdown. All 7 tumors were high stage at cystectomy and included 1 pT3a, 2 pT3b, and 4 pT4a tumors, and 3 had pelvic lymph node involvement. Follow-up data available in 6 cases revealed a poor outcome with an overall median survival of 8.5 months. In conclusion, we present an unusual morphology of bladder carcinoma that has a striking resemblance to a malignant vasoformative tumor. Our series showed that bladder pseudoangiosarcomatous carcinoma morphology is associated with a higher tumor stage at cystectomy, commonly admixed with other aggressive carcinoma variant morphologies, and portend a poorer outcome. Knowledge of this pattern is also important to avoid misdiagnosis, particularly in limited tissue samples.

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Section: Discussionmentioning

confidence: 99%

Pseudoangiosarcomatous Urothelial Carcinoma of the Urinary Bladder

Paner

Cox

Richards

et al. 2014

American Journal of Surgical Pathology

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“…A literature search using PubMed revealed 15 cases of angiosarcoma affecting the bladder, with the present case being the sixteenth 2 6–20. All cases are summarised in Tables 1–3.…”

Section: Discussionmentioning

confidence: 99%

“…All cases are summarised in Tables 1–3. Of these 16 cases, six cases involved prior exposure to abdominopelvic radiotherapy,10–13 17 20 one case initially presented with a cutaneous manifestation of angiosarcoma,19 one case appeared to be a variant of Kaposi’s sarcoma16 and two cases arose from haemangiomas,7 9 leaving five previous cases to be true primary bladder angiosarcomas with the current case being the sixth 2 6 8 14 15 18. With the inclusion of the current case, the mean age at diagnosis of true primary bladder angiosarcoma (excluding those mentioned above) is 54.5 (range 32–78).…”

Section: Discussionmentioning

confidence: 99%

Primary angiosarcoma of the bladder in a young female

Warne

Ong²,

Snowball³

et al. 2011

Case Reports

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Our case report pertains to a 32-year-old woman initially presenting with left flank pain and gross haematuria throughout her urinary stream. CT of her kidney/ureter/bladder (CT KUB) revealed ureteric dilatation to the level of the bladder without evidence of renal calculus and subsequently a stent was inserted. She represented a month later with contralateral flank pain, and a transuretheral resection of bladder tumour was performed. Histopathological diagnosis was epithelioid angiosarcoma. Further imaging (MRI pelvis) revealed that the tumour arose from the posterior bladder wall with local invasion and regional lymph node metastasis. Ifosfamide and epirubicin chemotherapy with single-fraction radiotherapy induced significant reduction in tumour bulk, although this initial response was followed by the development of symptoms suggestive of disease progression. She died 19 months after initial diagnosis with persistent pulmonary and vertebral metastases although no autopsy was performed.

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“…[118][119][120][121][122][123][124] These are uniformly aggressive tumours with high grade histology. Pathologically, bladder angiosarcomas are deeply invasive into the bladder wall, with histology similar to the lesion in other organs.…”

Section: Angiosarcomamentioning

confidence: 99%